Comparative costs of laparoscopically assisted vaginal hysterectomy

To audit the performance of laparoscopically assisted vaginal hysterectomy (LAVH) in a gynaecological practice with regard to cost and clinical outcome when compared to the surgical alternatives available.

LAVH was performed on 50 women and both monetary and time cost parameters analysed and compared with those of 30 women undergoing either abdominal hysterectomy, vaginal hysterectomy or endometrial resection.

The cost of LAVH was approximately twice that of abdominal hysterectomy and almost three times that of vaginal hysterectomy. The theatre time was longer for LAVH than for the above and in a similar ratio. Patient recovery was superior with LAVH when compared with abdominal hysterectomy but not when compared with standard vaginal hysterectomy.

LAVH has a role in providing patients with the option of avoiding abdominal hysterectomy, although the role will differ depending upon the differing criteria used by surgeons for selecting patients for standard vaginal hysterectomy.